1. 1 Anatomy Review Mouth Stomach Hepatobiliary Tree Small Intestine Large Intestine

2. 2 Oral Cavity Bacterial Diseases Dental Plaque –Accumulations of ________ (biofilm) –May calcify Dental Caries –_______________________ –Lactic acid erodes dental enamel Periodontal disease –Tooth support structures –_______________ – gum inflammation –_________________ – root of tooth also affected

3. 3 Oral Cavity Viral Diseases Mumps – Paramyxovirus –URT and salivary glands are affected –Resurgence recently due to complacency and failure to vaccinate –Complications – male sterility, meningitis, eye, ear infections, attack on other exocrine/ endocrine glands glands

4. 4 Gastrointestinal Bacterial Intoxications Staphylococcal Enterotoxicosis –High starch or cream content, high protein foods –Foods subjected to temperature abuse Cooked foods need to be covered/refrigerated to avoid bacterial growth and toxin production –Toxin can survive 30 minutes of boiling –Low mortality –Diarrhea symptoms 1-8 hr after food consumption

5. 5 Clostridium perfringens Enterotoxicosis Casseroles Anaerobic bacterium Toxin produced during ____________ formation Diarrhea 8-24 hr after food consumption Self-limiting *Also causes gas gangrene, see Nervous System diseases

6. 6 Gastrointestinal Bacterial Intoxications Botulism (______________________) –Consumed toxin can cause flaccid paralysis –Life support needed to prevent suffocation Bacillus cereus –Food poisoning associated with rice/ meat contamination –Found in water and soil Pseudomonas cocovenenans –Polynesian coconut contamination –Food poisoning may be fatal

7. 7 Bacterial Infections Enteritis –Inflammation of the intestine –Physical damage Invasion of cells by bacteria Dysentery Submucosal damage leads to blood and mucus in the stool –Gram negative bacteria may cause fever to accompany symptoms

8. 8 Bacterial Infectious Disease Salmonellosis –Poultry and poultry products –___________________________ 2000 strains Notifiable disease Strains help to trace public health problems to their source –Diarrhea 8-24 hr after food consumption –Self limiting, low mortality in infants and elderly

9. 9 Typhoid Fever __________________________ Human reservoir only Fever headache diarrhea Many organs invaded Less than 500 cases/yr in U.S.A. Drugs - Good public health measures prevent transmission

10. 10 Bacterial Infections Shigellosis _______________________ and others _____________ are a reservoir Contaminated water assists spread 10 bacteria may be enough to cause diarrheal disease 450,000 cases/yr in U.S.A. Symptoms for 2-7 days, self limiting Asiatic Cholera –____________________ –Developing nations –Rice water stool –Death due to __________________ –Rehydration therapy may be more effective than antibiotics

11. 11 Bacterial Intestinal Infection Vibriosis –_________________________ –Seafood associated –Marine bacteria, may also infect wounds –Self limiting 2-5 days Traveller’s Diarrhea –____________________ is a common pathogen –Water sources –Dehydration is biggest danger –Complications – IBS, lactose intolerance

12. 12 Bacterial Infections Enterohemorrhagic E. coli –______________________ –Shiga toxins cause intestinal hemorrhage, kidney failure, blindness –Children most sensitive –Ground beef, uncooked produce –3000 cases/yr estimated, 30 deaths in U.S.A.

13. 13 Bacterial Infectious Disease _________________________ –Food/H 2 O borne, copious diarrhea –Opportunistic –Second only to Salmonella in incidence –Animal intestines are source –Fluid replacement most important

14. 14 Bacterial Upper G.I. Disease Peptic Ulcer/Chronic Gastritis –__________________________ –Neutralizes stomach acid by degrading urea –4 million sufferers in U.S.A. –Treatment

15. 15 Viral Gastrointestinal Disease Viral Enteritis –Rotavirus –Entrovirus –Norwalk virus

16. 16 Viral Hepatitis Hepatitis A (HAV) –RNA virus –Oral-fecal transmission –Family transmission or contaminated water/shellfish –15 – 40 day incubation –Jaundice, fever, malaise, nausea, diarrhea, abdominal pain, anorexia –50% of cases asymptomatic –Self-limiting, immunity is gained –Vaccine since 1995

17. 17 Hepatitis B Ds DNA virus Blood to blood transmission Symptoms as for HAV but liver cell damage is occurring Vaccine recommended for all health care workers since 1986 Also recommended for infants (90% will become chronic carriers) Carrier status linked to cirrhosis and liver cancer in later life

18. 18 Protozoan GI Disease Giardia lamblia Balantidium coli Entameba histolytica